Telemedicine has been around for a long time with the idea of telemedicine as we know it today written about in the April 1924 issue of Radio News magazine. In 1959, the University of Nebraska used interactive telemedicine to transmit neurological examinations, which is widely considered the first case of a real-time video telemedicine consultation.1 Telemedicine continued to expand when it was adopted by the field of radiology and advanced through contributions from the National Aeronautics and Space Administration (NASA).
In the 1990, the rise of the Internet helped to expand telemedicine into areas like patient education, real-time audio and video consults, as well as the ability to take vital signs and other body measurements, like temperature and electrocardiogram (ECG) tests. Today telehealth is an established field that uses digital information and communication technologies, such as computers and mobile devices, to allow patients to access health care services remotely and take part in managing their health care.
Virtual appointments are now common for routine doctor visits and consultations for minor illnesses. These virtual “visits” with your doctor or nurse practitioner may involve a phone call or video conference call. Smart phones and visits over the internet from a laptop or desktop computer are a regular part of many physician practices.
The typical telehealth visit starts with a web-based tool that guides the patient through a series of questions. The doctor or nurse practitioner is able to see the patients, speak with them and assess how they look and respond, as well as assess the symptoms that the patient shares. The doctor or nurse practitioner may prescribe medications during the telehealth visit, suggest home remedies or recommend additional medical care.
In Palm Beach County, Florida, the C. L. Brumback Primary Care Clinics are offering both inpatient and telehealth services to patients who need medical attention.
“During the COVID-19 pandemic, telemedicine has greatly improved access for my patients who are working, traveling, have challenges with transportation or prefer to stay home,” said Vanessa Inacio, MD, adult provider with the C. L. Brumback Primary Care Clinics’ site in southwest Boca Raton. “My patients say they appreciate the flexibility of scheduling a telehealth visit from a private location, such as their car while they are at work. The flexibility of this type of appointment has increased my patients’ compliance with returning for their follow-up visits.”
Virtual appointments are excellent options for some patients. But while they are convenient, virtual appointments can have drawbacks. Often, a patient may not see their regular doctor. The virtual visit also lacks an in-person evaluation, which may make diagnosing the issue more difficult. If that is the case, it may lead to an in-person visit since the virtual appointment may not have resolved the medical issue.
Telehealth is much more than simply remote doctor visits. Advancements in technology allow your doctor to monitor your health remotely. For example, mobile and web-based applications allow patients to upload information like blood glucose readings to their doctor. Some applications allow for measurement and wireless transmission of blood pressure, blood glucose, and lung function.
For certain conditions, your doctor can provide you with a wearable device that automatically records and sends information to your doctor. Wearable devices can monitor hear rate, blood glucose, gait, posture control, tremors, physical activity, and sleep patterns. There are even home monitoring devices for older people who may have dementia. These devices can detect changes in normal activities such as falls.
Personal Health Apps
While telehealth typically is thought of as a direct connect or interaction between a doctor and patient, personal health apps can help consumers keep track of their medical information and become part of the patient care team. Examples of tools patients can utilize on their own include apps that store personal health information, including prescriptions taken. Others can be used to record vital signs, calculate and track caloric intake, reminders for taking medication, and recording physical activity, such as a daily step count.
Telehealth has transformed the doctor – patient relationship. Patients have greater access to medical care than ever before and doctors have more tools and real time information to help manage the health of their patients.
 Rashid Bashshur, PhD and Gary W. Shannon, History of Telemedicine: Evolution, Context, and Transformation. New Rochelle, NY: Mary Ann Liebert, 2009.
About the Health Care District
The Health Care District of Palm Beach County provides primary medical care, dental services and COVID-19 testing for adults and children at the C. L. Brumback Primary Care Clinics, health coverage programs for eligible uninsured residents, a pharmacy operation, a nationally-recognized Trauma System, registered nurses in nearly 170 public schools, short and long-term skilled nursing at the 5-star rated Edward J. Healey Rehabilitation and Nursing Center in Riviera Beach, and acute care at its teaching hospital, Lakeside Medical Center, which is accredited by The Joint Commission and serves the rural Glades’ communities.